Leg Pain

The American Chiropractic Association sponsored a study to try and determine what people were doing about their back pains. 800 adults were surveyed, all of whom were suffering from chronic low back pain at the time of the survey. To properly frame this study it’s important to realize that 80% of people will have at least one incident of lower back pain sometime in their lives. The second most common reason to visit a doctor is back pain, and the cost of this so-called benign condition is over $90 billion dollars in the US alone; which is, evidently, about 1% of the gross domestic product. According to the article, lower back pain is the most common cause of disability in people under 45. With all these facts in mind, knowing what people do to try and help their pains and where chiropractic fits in is very relevant.

Some of the survey’s findings were surprising. 85% of people surveyed had suffered from lower back pain for 3 years, 71% for 5 years or more, so you can readily see that we are not dealing with the general population here. The causes of pain listed by those surveyed ranged from an injury or accident (18%), degenerative disc disease(12.5%), herniated disc (10.3%), arthritis (10%) to “nothing” (2.6%).

For 65% of these people when their pain first began, their first treatment choice was medicine, their GP or family doctor. 18.8% chose to see a chiropractor. Of course, the most common form of treatment was drugs: 27% analgesics or narcotics, 25% OTC meds such as Tylenol or Advil, 19.6% used muscle relaxants and 18% took nonsteroidal anti-inflammatories. Many people actually took a combination of these drugs. 10.8% the 800 people surveyed used chiropractic to control their pain.

So, in spite of all these drugs, it would appear that most people found their treatments to be largely ineffective because 40% reported their back pains as “severe” or “very severe”, while less than 31% felt that their pains were “under control” or “completely under control”. Over 40% of those questioned said that their pains were “not under control” or “not under control at all”. Sad isn’t it? All those drugs, with their inherent and potentially lethal side-effects and such poor results; drugs for chronic lower back pain simply don’t work that well.

Here’s an interesting thing: 64.4% of people said that they would consider seeing a chiropractor and over 80% answered that they would prefer to avoid medications. So you need to ask yourself, “If the drugs they are taking are mostly ineffective, if they would prefer not to take drugs at all, and 2/3’s would consider going to a chiropractor, why aren’t more going?” That’s a great question, and I wish I had an answer. Perhaps it’s the cost. In some circles, chiropractic care is seen as expensive and elitist. Maybe it’s our image, we are often perceived to be somewhat “kooky”, and a few chiropractors admittedly do go “over the top” with their claims. We have had a pile of bad press in the past couple of years, but that’s not really new. Our critics in medicine seem to go to great lengths to discredit us in the media. But perhaps we, as a profession, need to do more public education. Chiropractic is a wonderful and effective alternative. We offer people a choice as a safe, natural and drug-free method of pain control. Not just lower back pain, but neck, shoulder, arm, hip and leg pain as well. Why not give us a try?
Source: This study was written up in the October 7th, 2004 edition of Dynamic Chiropractic, our profession’s largest periodical.

Growing Pains a.k.a. non-specific leg pain. As many as 10-20% of children may complain of vague leg pain on a recurrent basis. The diagnosis commonly provided is, "growing pains" The pain is usually unilateral and is located deep in the leg most commonly in the thigh, knee or calf. This type of leg pain typically occurs at night when the child is in bed and lasts 30 minutes to one hour. Systemic signs and symptoms are absent and x-ray findings and blood tests are normal.

The problem is most likely caused by sacroiliac subluxation on the side of leg pain and usually responds immediately to adjustments of the associated area.
Source: By: Peter N. Fysh, D.C., B.App.Science - International Review of Chiropractic - January/February 1993

As a chiropractor who has been in practice for 28 years, I have seen hundreds of cases of sciatica. Most times these conditions clear up relatively quickly with spinal adjustments to the lower lumbar vertebrae and sacroiliac joints. But occasionally, a case of sciatica will prove to be chronic and difficult to respond. A sciatic sufferer sometimes needs to be what he is known as …”patient” while I continue to do what I do…”practice”.

Sciatic neuralgia is mostly caused by irritation of the sciatic nerve as it exits the lower spine from between the lumbar vertebrae. These vertebrae can irritate or “pinch” the nerve due to one or more physical scenarios. A loss of normal motion between these bones can result in an irritation of the sciatic nerve. A degenerative process in the intervertebral disc can cause mechanical pressure to the nerve. A misplacement of one of the vertebrae can mechanically pinch the nerve. A swelling, protrusion or herniation of the disc can also pinch the nerve.

All of these conditions respond well to chiropractic care, some quicker than others. An actual herniation of an intervertebral disc, however, is an extremely tough clinical condition for a chiropractor to deal with alone. These patients are generally in very acute difficulty, often completely disabled, barely able to arise from bed and in excruciating pain. These patients require strong analgesics and even narcotics often times do not give them adequate relief. Acute sciatica is said to be the worst pain that a human has to endure next to stones in the renal ureter.

The sciatic nerve arises from the spine in the lower 3 lumbar vertebrae and is the longest and largest nerve in the body. As it passes through the upper gluteal region, it is frequently as thick as your thumb. When it becomes inflamed it creates a condition which we call sciatica. Not all leg pain is sciatica, but virtually all sciatica involves leg pain. Usually felt in the back of the thigh, calf, ankle and top or bottom of the foot, sciatica often causes sensations of burning, cramping, tingling, numbness and depending on the level of acuteness, degrees of pain ranging from an aching nuisance to throbbing to extreme and overt pain. In severe cases, absent or diminished reflexes and wasting or atrophy of muscles can occur. In rare instances, a patient can even lose bladder and bowel control.

Causes of sciatica are varied. It can result from a sudden trauma, a strenuous attempt to lift, pull or push something, a false or sudden rotational motion, or even the jolt of a violent sneeze or cough. Most times, however, sciatica is the result of cumulative or repetitive small traumas. Sciatica may appear suddenly or gradually and may first be noticed while walking or slouching in a chair. It is often the result of some trauma that occurred months or even years before. Generally, I have noticed, the sciatic sufferer has had a history of minor low back occurrences, which they have chosen to ignore. And because that soreness that they felt upon arising each morning always went away after a bit, the person assumed that AM pain was “normal”.
Sciatica can also be related to various non-spinal conditions, such as constipation, advanced diabetes, tumors and even some vitamin deficiencies. Other musculoskeletal conditions can result in a bout of sciatica. Spasms, hypertonicities, and bursitic conditions in and around the hip and gluteal region can also irritate the sciatic nerve.

Sciatica is ultimately about inflammation of the nerve. Therefore, rest, ice when acute and care not to cause further irritation, will cause the pain to eventually resolve by itself. However, if the original cause is not identified and corrected, further episodes are a very real possibility. This process of spontaneous resolution may take weeks and often is not complete; often leaving the individual with residual leg or hip pain, numbness, muscle weakness, and reduced stamina, especially with walking.

It is best with these conditions to get some professional advice as early attention can often mean much earlier resolution. As chiropractors, we have been recognized as experts in the area of low back problems and sciatica for decades. Consequently, it would behoove someone suffering from sciatica to seek the help of a reliable and experienced chiropractor.

Author: Dr. David L. Phillips
Published on: June 12, 2001